Incision and removal of foreign body, subcutaneous tissues; simple

CPT 10120 is the billing code for "Incision and removal of foreign body, subcutaneous tissues; simple". For simple incision and removal of foreign body from subcutaneous tissues

Medicare pays approximately $147.18 for CPT 10120 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 10120 has a total RVU of 5.95, broken down as: Work RVU 2.50, Practice Expense RVU 3.20, and Malpractice RVU 0.25. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 10120 include: Location of foreign body; Type and size of foreign body; Method of removal; Wound closure technique. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 10120: Includes incision and removal. Includes local anesthesia Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 10120 include: 51 (Multiple procedures performed same session), 59 (Distinct procedural service if performed separately), LT (Left side procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 10120 is 15-30 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.